Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information.The nurse or midwife should refer a patient to a registered dietitian for in-depth nutritional counseling in the following situations: (Select all that apply.)

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The nurse should be especially aware that conditions such as diabetes can require in-depth dietary planning and evaluation.To prevent issues with hypoglycemia and hyperglycemia and an increased risk for perinatal morbidity and mortality,this patient would benefit from a referral to a dietitian.Consultation with a dietitian may ensure that cultural food beliefs are congruent with modern knowledge of fetal development and that adjustments can be made to ensure that all nutritional needs are met.The obese pregnant patient may be under the misapprehension that because of her excess weight little or no weight gain is necessary.According to the Institute of Medicine,a patient with a body mass index in the obese range should gain at least 7 kg to ensure a healthy outcome.This patient may require in-depth counseling on optimal food choices.The vegetarian patient needs to have her dietary intake carefully assessed to ensure that the optimal combination of amino acids and protein intake is achieved.Very strict vegetarians (vegans)who consume only plant products may also require vitamin B and mineral supplementation.A patient with a food allergy would not alter that component of her diet during pregnancy; therefore,no additional consultation is necessary.

Most Women with Uncomplicated Pregnancies Can Use the Nurse as Their